Our Strategy
We partner with governments to build strong community health systems that equip professional community health workers to provide essential primary healthcare in the world’s most remote communities.
Half the world’s population lacks access to essential primary healthcare, and nearly nine million people around the world die each year from preventable causes, simply because of where they live. This gap is particularly acute in remote communities, where an estimated two billion people live outside of the reach of healthcare.
Last Mile Health was founded in 2007 to solve this injustice.
Beginning in Liberia’s hardest-to-reach communities, we partnered with the government to train community health workers to provide a full package of primary care services with a focus on those most at risk: mothers and children. These paid, professional community health workers deliver door-to-door care to their neighbors, connecting them to services ranging from antenatal care to childhood immunizations and providing treatment and referral for conditions like malaria, malnutrition, and pneumonia. They’re integrated into the formal health system, playing a critical role in surveillance and response during epidemics and pandemics like Ebola and COVID-19 while maintaining routine care amid crisis. In the world’s most rural, remote, and under-resourced contexts, community health workers save lives.
Today, our work is demonstrating that it’s possible to bring care within reach for all. As of December 2025, we support more than 30,000 community health workers serving nearly 52 million people in four countries. Alongside our government partners in Ethiopia, Liberia, Malawi, and Sierra Leone, we’re building strong, sustainable systems that equip those community health workers to deliver essential care. Together, we develop and implement interventions that improve program quality while driving down costs, with an emphasis on digital health innovations—like a blended learning approach for community health worker training in Ethiopia that has reduced costs by 39% while boosting learning gains. Maternal and child health remains our guiding star, and community health worker programs in the countries where we work have driven promising gains in areas including immunization rates and facility-based delivery.
As massive shifts in global health financing put lives at risk, we’re scaling what works: high-impact care delivered by professional community health workers. Throughout our current five-year strategic period (July 2023–June 2028), Last Mile Health will deepen our impact in four to six community health systems and influence community health financing in service of ensuring that more people can equitably access quality healthcare. We will work with the governments of Ethiopia, Liberia, Malawi, and Sierra Leone (with the potential to scale to one to two additional countries in Africa) to improve community health systems. In parallel, we will influence community health funding, practice, and policy across Africa to improve how sustainable funding is invested in community health as part of Africa Frontline First. Our approach will build cost-effective, resilient, sustainable systems that will drive progress toward health for all, centered on those who need it most.
Guided by our three-part theory of change, we will realize our strategy by working to:
Facing far fewer resources from international aid, governments need solutions that are cost-effective, locally led, and built to last. Already, Last Mile Health is working alongside our government partners to reduce community health program costs through innovation while advocating for increased domestic funding. Through Africa Frontline First, we’ve made huge strides in ensuring financial resources are applied to what works. In addition, we’ve open-sourced our Six S approach, providing a blueprint for peer organizations and governments and shifting norms at global institutions including WHO and UNICEF.
Supporting more community health workers to deliver care is a crucial step forward—but what we’re doing is far bigger than this. We’re catalyzing a continent-wide shift in how healthcare is delivered and financed, ushering in a sea change for hundreds of millions of patients. This is how we can save lives together, now and for years to come.
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TO BRING A HEALTH WORKER
WITHIN REACH OF EVERYONE,
EVERYWHERE.
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